- © 2017 Marshfield Clinic
Treatment-Refractory Sternocostoclavicular Hyperostosis
- Ralph Yachoui, MD*⇑,
- Mazen Kreidy, MD† and
- Brian J. Parker, MD‡
- *Department of Rheumatology, Marshfield Clinic, Marshfield, Wisconsin, USA; Current affiliation: Division of Rheumatology, Department of Medicine, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, California, USA
- †Department of Pulmonary/Critical care, Marshfield Clinic, Marshfield, Wisconsin, USA
- ‡Department of Radiology, Marshfield Clinic, Marshfield, Wisconsin, USA
- Corresponding Author:
Ralph Yachoui, MD, Division of Rheumatology, Department of Medicine, David Geffen School of Medicine, University of California-Los Angeles, 10833 LeConte Avenue, Los Angeles, California 90095, Phone: (310) 825-6373, Email: ryachoui{at}mednet.ucla.edu
Abstract
Sternocostoclavicular hyperostosis (SCCH) is an infrequent chronic inflammatory disorder of the axial skeleton of unknown origin. SCCH goes often unrecognized due to a low level of awareness for the disorder. It typically presents with relapsing and remitting pain in the shoulder, neck, and anterior chest wall area with occasional swelling and tenderness of the sternoclavicular area. The diagnosis is confirmed radiologically by sclerosis and hyperostosis of the sternoclavicular joints. There have been several reports in which intravenous bisphosphonates and tumor necrosis factor-inhibitors have shown reasonable efficacy in the treatment of this disorder. We report a patient with a long history of SCCH in whom pamidronate 60 mg intravenously every 3 months for 3 years failed to reduce symptom severity and improve radiologic findings.
